Spiritual Coping

I very much enjoyed engaging with those who attended the I CAN COPE program last month.  I illustrated the concept of “spiritual coping” using the words of a spiritual caregiver who had received a cancer diagnosis and was able to beautifully articulate her own process of spiritual coping as she proceeded with treatment. Sometimes we hear elements of our own stories in that of another; sometimes we learn something new!

Stories of spiritual coping seem to have common elements that I want to present to you.  These days, people often make a distinction between religion and spirituality, saying that they are either “religious” or “spiritual” (or neither). BOTH can be important for spiritual coping, but it’s important to understand what these terms imply.  To speak of being religious usually means that the rituals and beliefs of a particular religion or denomination will be important for a person’s well-being during treatment.  Those who refer to themselves as “spiritual” may or may not be actively connected to a religious group; they generally emphasize life experience, both mystical and practical, for meaning and purpose as they proceed with treatment.   

Here at Holy Cross I aim to help all persons to access and incorporate the healing aspects of religion and / or spirituality for themselves.  As we continue this conversation, I would begin by suggesting to each one of you a starting point for your own consideration: Find a quiet place where you can take a few moments to begin to become aware of what has been life-giving for you in your spiritual and religious life. Write down your insights. This will be the starting point for your spiritual coping.

Tags: faith, i can cope, spiritual, spiritual care
Posted in Cancer Support, Spirituality |

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Breast Ultrasounds Are Essential

I recently attended the annual American Society of Breast Surgeons meeting in San Diego.  One of the points that was stressed at the meeting was that breast surgeons should be using breast ultrasound – both in their offices and in the operating room. 

In the office, breast ultrasound acts as an extension of the physical exam.  When a woman comes to my office with a breast lump, I can immediately perform an ultrasound to help diagnose the cause of the lump.  It can also be used to better assess the lymph nodes under the arm.  Further, if the ultrasound findings are concerning, I can use the ultrasound to guide a biopsy or aspiration.  All of this can be done at the patient’s first visit to get a diagnosis as soon as possible.  Waiting for a diagnosis causes a lot of anxiety, and having an ultrasound in my office speeds the process along so we can get an answer fast. 

In the operating room, ultrasound can be used to visualize the lesion that needs to be removed.  Seeing the lesion clearly allows the surgeon to make smaller incisions that can be placed in more cosmetically appealing locations.  It can also be used to make sure that the lesion is removed completely with adequate margins. 

Overall, ultrasound is rapidly becoming a necessity for breast surgeons.  Besides having the actual machine available, breast surgeons need to be trained to perform, interpret, and document breast ultrasound properly.  Having completed a breast fellowship, I was fortunate to obtain the training needed for breast ultrasound.  I have the ultrasound available in both my office and in the operating room, and use it to provide the most up-to-date care to my patients.

Tags: american society of breast surgeons, breast cancer, breast ultrasound, ultrasound
Posted in Breast Cancer Surgery, General Medical |

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Trials try to Light the way to a Cure

Clinical trials are the only road to new standards of care in medicine. Without their scientific rigor, we would not be able to move forward to improve and hopefully someday, eliminate diseases.

There are many different types of clinical trials in cancer care. Here at the Bienes Cancer Center, we do mainly treatment, screening and prevention trials. I want to share an example of a National Cancer Institute funded prevention trial that we are participating in.

The Selenium and Vitamin E Cancer Prevention Trial (SELECT) is a clinical trial to see if one or both of these dietary supplements prevent prostate cancer. Over 35,000 men were enrolled across the USA, Canada and Puerto Rico. The study was based on findings from two separate studies in the past for cancer prevention. One looked at the use of vitamin C in multiple cancers and it indicated a reduced incidence of prostate cancer with this vitamin. The other study was testing the use of vitamin E in the reduction of many cancers and it also showed a reduced incidence of prostate cancer.    

The Bienes Cancer Research department has enrolled 121 men into this study since its inception in 2001. Each subject was randomized to combinations of Vitamin E, selenium or placebo. The men took their pills daily, came into the clinic for annual PSA tests and digital rectal examinations by our physicians. They also received phone calls every six months to gather more health related information. Recently, another component has been added to gather information about the incidental findings for any men in this trial who happened to have had a colonoscopy.

The pills were stopped in August 2008 because the data showed that taking vitamin E and selenium alone or together does not prevent prostate cancer. The data also showed that vitamin E may slightly increase the chance of getting prostate cancer. Selenium may be associated with a slightly increased risk of developing diabetes mellitus. However, these findings are not statistically significant and may be due to chance alone.

These men will remain on trial for another 2-3 years as we gather more health related findings. Although this trial did not reach its goal of a 25% reduction in prostate cancer, it has shown that the previous findings concerning vitamin E & C in the prevention of prostate cancer were not verifiable. Six men, who were not having regular prostate exams and PSAs, were found to have early stage prostate cancer. To read more about this trial, please visit the NCI website. 

If you have been or are enrolled in this trial, we would love to hear about your personal experience and any thoughts you have about this or other prevention trials.

Tags: cancer prevention, clinical trials, National Cancer Institute, Prevention, Prostate Cancer, Screening, SELECT, Selenium, Treatment, vitamin C, Vitamin E
Posted in Prostate Cancer, Research and Genetics |

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Overcoming Obstacles

Our Spring 2009 “I Can Cope” cancer educational program on Saturday, April 25th offered riveting information from our speakers. 

The small but engaged group of participants stayed until the end.  They had wonderful praises about the program, stating that each presenter built on the previous and that the information they received during the program was invaluable.  The newly-diagnosed patients and their families were especially grateful for the information. 

One of the wonderful things about this educational support program is the combination of patients with varying diagnoses and stages; some attend the Bienes Comprehensive Cancer Center, some were planning to start treatment, and others were from other community oncology practices.  The “I Can Cope” program, like most of our support groups, is open to the local community. 

I thank our presenters, Dr. Leonard Seigel, one of our medical oncologists; Dr. Irina Grosman, one of our radiation oncologists, Mr. Alton Linn, Esq.; Dr. Kushch, a local psychologist, and Reverend Joanne Afshar.  We were even fortunate to have a Social Security Administration’s representative to educate us about the criteria and the application process for disability benefits.

By the end of the session, the participants were celebrating their lives and grateful for the day’s resounding message that “overcoming our obstacles” was the key to a positive cancer journey.

Tags: Cancer Education, Disability Benefits
Posted in Cancer Support, General Medical |

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